The third South African National AIDS Conference, held in Durban this week, bringing together international and local scientists, opinion-makers, activists, care-givers and officials all working in the arena of HIV and AIDS, happens at an important time when South Africans of all sectors have taken two giant leaps.

One, we have restructured and reinvigorated the South African National AIDS Council (SANAC) and two, we have adopted the National Strategic Plan for HIV and AIDS and Sexually Transmitted Infections for 2007-2011. This strategy will promote shared scientific knowledge and integrated approaches to the management of HIV and AIDS and its impact on our continent.

An interaction of scientists, opinion-makers, activist, caregivers and officials is bound to yield rich knowledge and new challenges. It is through such constructive interactions that honest views and genuine partnerships emerge and are consolidated. The multi-sectoral nature of the conference demonstrates the complexity of the disease, the need to take a holistic approach and to also deal with socio-economic issues.

This pandemic has forced us to work together as we recognised that the sum of the whole is bigger than its parts. We are learning that we have to work in new ways and paradigms. We are adapting to the relevant challenges of the day. Changes in our communities affect the practice of religion, culture, medicine, social development, politics, education in schools, economics, and in our sexual conduct, all have had to take into account the reality of HIV and AIDS. However, at a personal level, responsibility and power lies with each and every one of us to change the patterns of transmission and the impact of HIV and AIDS. Each one of us whether HIV negative or positive has a special role to play.

As per the goals of the National Strategic Plan (NSP) we must have activities that we can monitor whose impact we can gauge. There are signs to suggest that the South African HIV and AIDS epidemic has now reached its peak with about 12% of a total population of 46 million estimated to be living with HIV. Some of these infections have not been identified. New infections still occur; many people require treatment, care and support.

Unfortunately, those who do not know their status as a result cannot access treatment when they have to, and have become major sources for the spread of the disease in the general population. We have been pointing out the impact of the pandemic on women, but we must be concerned about the fact that men are less likely to know their status, yet they are the ones who tend to have multiple partners and are less enthusiastic about protected sex. There is a lot that we still do not know about men and need to know hence the importance of the men's sector and the focus on lifestyle changes and testing by men.

A fairly large number of adults and children that have been identified as HIV positive have access to a range of interventions including treatment of opportunistic infections, nutrition, antiretrovirals (ARV), and terminal palliative care. All of which requires us to plan and use our human resource very wisely and optimally. Contrary to many urban legends about South Africa, this country has the largest ARV programme in the world, but it is also true that the estimated need is huge, the scale of the problem requires for us to continue to find innovative ways to quicken the pace of increasing access to health services.

We are also aware that we have to manage our resources in a manner that provides a better health system for all, and to respond to the challenges of building a healthy nation.

We need as suggested by the theme to build consensus, on many fronts, on prevention, treatment, and care. Government is thankful that we have in South Africa reached a consensus on the national response to HIV and AIDS and STIs for the next five years, as contained in the NSP.

Beyond these collective responsibilities, various professional groups in our society have additional specific responsibilities. Traditional leaders have a critical responsibility to enforce the protective traditional practices that promote the health of our people. They also have the responsibility to discourage traditional practices that may not have been harmful in the past, but which, in the present age, enable HIV to spread. In many communities they are the opinion leaders in shaping community social values.

To our traditional healers we say: we encourage you to work with the health care system to heal people who are ill and to facilitate referrals for those who need treatment in clinics and hospitals. We need you to counsel and help people take their treatment and to lead healthy lifestyles.

Health workers, civil servants and caregivers have a specific responsibility to provide evidence-based prevention, treatment, care and support services in partnership with organisations in communities.

Scientists are another professional grouping that has specific responsibilities. It is vital that scientists go beyond conducting scientific studies to working with policy makers to translate evidence into interventions and programmes. They also have to ensure that their research contributes to the monitoring and the evaluation of the National Strategic Plan. We must manage the public announcements on prevention and claims of cure that if not managed properly can send messages that encourage risky behaviour.

South Africa would like to be part of the global networks that do research and contribute to finding solutions. Our scientists also have a responsibility to develop the capacity of the next generation researchers. A successful scientist should be the one who has developed others to do what they are good at. More of our young people must be encouraged to become scientists so they can develop new prevention, treatment and care approaches. South Africa wants to build and has the capability to be part of the global pharmaceutical economy.

We also have skills to help our country to cope with task of caring for millions of vulnerable and orphaned children. Our AIDS activists are mobilising in communities; the recent South African Local Government Association conference deliberated on mainstreaming the NSP in municipalities; and the South African media is endorsing it.

Through the Inter-Ministerial Committee, government will continue to give guidance on the implementation of this national plan. Many South Africans now know about the ambitious targets of halving the rate of new infections and covering 80% of identified HIV positive individuals with appropriate services during the strategic plan period.

We shall continue to support research both to improve our service delivery systems and approaches and to look for better prevention and treatment options. We have identified a set of measurable indicators by which to monitor progress with implementation.

The monitoring and evaluation framework of the strategic plan allows for alignment with relevant regional and international commitments, and it allows for periodic surveys, reviews and regular surveillance. We have a broad sense of the required financial resources. Serious discussions have been held with government and business around this matter.

A detailed costing study is underway, and we shall return to these major players with a more specific request and our development partners and major foundations will be guided to a defined financial gap. Capacities to spend as well as the risk management mechanisms will need to be enhanced.

This is a three-year social mobilisation programme, a critical element of which is communicating the details of the plan to the general public, while educating South Africans on specific HIV and AIDS prevention, treatment, care and support programmes.

Some government departments and civil society sectors are busy with the operationalisation of the NSP for their environments. There are specific targets that we set ourselves for the year 2007, and we must deliver on these activities.

The convergence of scientists, academics, non-governmental organisations, donors and activists this week is an opportunity to share new knowledge and insights in building consensus for prevention, treatment and care.

Phumzile Mlambo-Ngcuka is a member of the ANC National Executive Committee and Deputy President of South Africa. This is an edited extract of a speech at the opening of the third South African AIDS Conference, 5 June 2007.

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